Stand alone energy-based tissue clips

ABSTRACT

A tissue clip for use in electrosurgical procedures includes an arm having a first electrode formed thereon. The tissue clip also includes a body pivotally coupled to the arm. The body includes a power source and a second electrode. The arm is moveable from a first position relative to the body for approximating tissue and a second position closer to the body for grasping tissue therebetween.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation application of U.S. patentapplication Ser. No. 13/179,960, filed on Jul. 11, 2011, the entirecontents of which are incorporated by reference herein.

BACKGROUND 1. Technical Field

The present disclosure relates to the use of energy-basedelectrosurgical instruments. More particularly, the present disclosureis directed to the use of stand alone energy-based tissue clips toprovide energy to seal, cauterize, ablate or destroy cells and/ortissue.

2. Background of the Related Art

Surgical staplers are widely used to join or bond tissues together andto provide hemostasis of adjacent tissues. These staples can be employedin combination with electrosurgical stapling apparatus where thermogenicenergy is utilized to provide short-term hemostasis and sealing. Onedrawback of using staples is that staples generally remain inside thebody.

Another method of joining or bonding tissue is based on radio frequency(RF) energy applied to tissue. Existing RF energy-based tissue sealinginstruments utilize metal electrodes combined with jaws which grasp andhold sealed tissue. Energy-based tissue sealing involves compressingtissue to bring vessel walls together, heating compressed tissue by RFcurrent up to the temperature of denaturizing and mixing of collagen andelastin, and cooling down and solidification of the melted collagen andelastin to form the seal.

This approach has several disadvantages which are inherent to mostenergy-based sealing instruments. Compressing and heating of tissuetakes considerable time in which the surgeon has to hold the instrumentand wait. This may interfere with the continuous flow of a surgicalprocedure. In order to reduce sealing time, power has to be increasedthat may result in higher risk of thermal damage and to more bulkyinstrument and generator designs. Additionally, after several cycles ofsuccessive sealing, the jaw members of the electrosurgical instrumentmay become overheated and a surgeon may need to wait until they cool toavoid poor quality sealing and thermal damage of adjacent tissues.

SUMMARY

In an embodiment of the present disclosure, a tissue clip is providedhaving an arm with a first electrode and a body pivotally coupled to thearm. The body includes a power source and a second electrode. The arm ismoveable from a first position relative to the body for approximatingtissue and a second position closer to the body for grasping tissuetherebetween.

The body may include an antenna configured to transfer energy from thepower source to the first and/or second electrode. The body may alsoinclude an antenna configured to communicate with an external controlunit. The tissue clip may further include a sensor array to determinetissue parameters of tissue between the arm and the body.

In one embodiment, the first electrode and/or second electrode mayinclude a stainless steel layer and a copper layer. Alternatively, thefirst and/or second electrode may include at least one piezo electricsensor. In another embodiment, the first electrode may include an outerlayer composed of a non-stick material and flex circuit having a coilformed thereon.

The first electrode and second electrode cooperate with the control unitand the power source to seal tissue. The tissue clip may also include acutting element having an electrode configured to electrically cuttissue. The cutting element cooperates with a control unit to cut tissueafter seal is completed. The tissue clip may also include at least onesensor configured to sense a completed seal and the control unitautomatically activates the cutting element when the at least one sensorsenses the completed seal.

In yet another embodiment, the first electrode includes a first pair oftissue contacting surfaces and an insulator disposed therebetween andthe second electrode includes a second pair of tissue contactingsurfaces and a pair of insulators disposed between the second pair oftissue contacting surfaces. A cutting element is disposed between thepair of insulators. The cutting element may be moveable to cut tissuebefore, during or after the formation of a tissue seal. The cuttingelement includes an electrode that is configured to electrically cuttissue

In another embodiment of the present disclosure, a tissue clip isprovided that includes an arm having a fiber grating and a bodypivotally coupled to the arm. The body includes a power source, a fibergrating and a light source coupled to the fiber grating in the arm andthe fiber grating in the body. The arm is moveable from a first positionrelative to the body for approximating tissue and a second positioncloser to the body for grasping tissue therebetween.

The body may include a control unit configured to transfer energy fromthe power source to the light source to.

The fiber grating in the arm and the fiber grating in the body cooperatewith the control unit and the power source to seal tissue.

The arm and/or the body includes a cutting mechanism configured to cuttissue disposed between the arm and the body wherein the cuttingmechanism cuts the tissue disposed between the arm and the body before,during or after the tissue is sealed. The cutting mechanism may includean electrode configured to electrically cut tissue. The cuttingmechanism cooperates with a control unit to cut tissue after seal iscompleted. Alternatively, the cutting mechanism may include a lightsource configured to emit a focused light to cut tissue.

In yet another embodiment of the present disclosure, a tissue clip isprovided that includes an electrode assembly, a first arm, a second armmoveable from a first position relative to the first arm to approximatetissue to a second position closer to the first arm for grasping tissuetherebetween, a first electrode disposed on the first arm, a secondelectrode disposed on the second arm, and

The electrode assembly is configured to seal tissue and may cooperatewith a control unit to seal tissue. The electrode assembly may alsoinclude a pair of first terminals coupled to the first electrode and thesecond electrode.

The tissue clip may also include a body having a power source, a controlunit coupled to the power source and a pair of second terminals coupledto control unit, the pair of second terminals configured to receive thepair of first terminals. The electrode assembly may be removably coupledto the body.

The electrode assembly may be absorbable and the body may be reusable.In one embodiment, the power source may be removably coupled to thebody. In another embodiment, the power source is included in the body.The power source may also be removably coupled to the electrodeassembly.

In yet another embodiment of the present disclosure, a tissue clip isprovided having an electrode assembly with a first electrode and aretaining clip. The tissue clip also includes a body having a secondelectrode and a power source. The retaining clip couples the electrodeassembly to the body to grasp tissue between the first electrode and thesecond electrode.

The body may include a control unit coupled to the power source. Theelectrode assembly may further include a power source, and at least onesensor to determine a parameter of the tissue grasped between the firstelectrode and the second electrode. The electrode assembly may alsoinclude a control unit coupled to the power source wherein the controlunit controls sealing of tissue.

The body further includes at least one sensor to determine a parameterof the tissue grasped between the first electrode and the secondelectrode. The power source in the body may provide energy to the firstelectrode.

In yet another embodiment of the present disclosure, a method forsealing tissue is provided. The method includes providing a tissue cliphaving a first portion having a first electrode and a second portionremovably coupled to the first portion. The second portion includes apower source, a second electrode and a control unit configured totransfer energy from the power source to the first and/or secondelectrode. After providing the tissue clip, tissue is approximatedbetween the first portion and the second portion. The tissue is graspedbetween the first portion and the second portion by moving the firstportion from a first position relative to the second portion forapproximating tissue to a second position closer to the second portionfor grasping tissue therebetween. Then the power source is activated toseal tissue.

In yet another embodiment of the present disclosure, a tissue sealingsystem may be provided that includes an external control unit and atissue clip. The external control unit includes a power source and atransmitting coil. The tissue clip includes a body, a first arm movablerelative to the body to grasp tissue and a receiving coil operativelycoupled to at least one electrode disposed in one of the body and/orfirst arm. The transmitting coil induces a current in the receiving coilthat is supplied to the at least one electrode to thermally treattissue.

In yet another embodiment, a tissue clip is provided that includes acontrol portion having a power source and a clip portion. The clipportion includes a first arm, a second arm, and at least one electrode.The clip portion may be removably coupled from the control portion. Thecontrol portion may also include a control unit configured to transferenergy from the power source to the at least one electrode.

In one embodiment, the clip portion includes a shape memory alloy,wherein the first arm moves relatively closer to the second arm when thetissue clip is heated. In another embodiment, the clip portion includesa spring member configured to bias the first arm toward the second arm.The first arm and the second arm apply a closure pressure to seal tissuebetween 3 kg/cm² to 16 kg/cm².

In yet another embodiment, a tissue clip is provided having a first arm,a second arm, and helical torsion spring. The first arm includes a powersource and at least one electrode. The helical torsion spring isconfigured to couple the first arm to the second arm. The helical coilspring biases a proximal end of the first arm toward the proximal end ofthe second arm to grasp tissue therebetween. The helical torsion springcauses the first arm and the second arm to apply a closure pressure toseal tissue between 3 kg/cm² to 16 kg/cm². The tissue clip may alsoinclude at least one stop member configured to provide a gap between thefirst arm and the second arm during sealing in the range of 0.001 inchesto 0.006 inches. The first arm may also include control unit configuredto transfer energy from the power source to the at least one electrode.

In the embodiments described above, during a sealing procedure, the armsclose with an appropriate closure pressure to seal tissue, e.g., 3kg/cm² to 16 kg/cm².

As mentioned above, it is contemplated that the tissue clip embodimentsdescribed herein can use light, microwave, RF, or resistive energy tothermally treat tissue or seal tissue (as defined herein).

BRIEF DESCRIPTION OF THE DRAWINGS

The above and other aspects, features, and advantages of the presentdisclosure will become more apparent in light of the following detaileddescription when taken in conjunction with the accompanying drawings inwhich:

FIG. 1A is a schematic diagram of a tissue clip according to anembodiment of the present disclosure;

FIG. 1B is a schematic diagram of a tissue clip according to anotherembodiment of the present disclosure;

FIG. 1C is a schematic diagram of a tissue clip according to anotherembodiment of the present disclosure;

FIG. 2 is a schematic diagram of an electrosurgical system utilizingtissue clips according to an embodiment of the present disclosure;

FIG. 3 is a system block diagram according to an embodiment of thepresent disclosure;

FIG. 4 is a schematic diagram of a tissue clip according to anotherembodiment of the present disclosure;

FIG. 5 is a system block diagram of the tissue clip of FIG. 4;

FIG. 6 is a schematic diagram of a jaw portion according to anembodiment of the present disclosure;

FIG. 7 is a schematic block diagram of an electrode suitable for use ina tissue clip according to another embodiment of the present disclosure;

FIG. 8 is a schematic block diagram of an electrode suitable for use ina tissue clip according to another embodiment of the present disclosure;

FIG. 9 is a schematic block diagram of an electrode suitable for use ina tissue clip according to another embodiment of the present disclosure;

FIG. 10 is a cross sectional view of an electrode assembly of a tissueclip according to another embodiment of the present disclosure;

FIG. 11 is a schematic diagram of a tissue clip according to anotherembodiment of the present disclosure;

FIG. 12 is a system block diagram of the tissue clip of FIG. 11;

FIG. 13A is a schematic block diagram of a tissue clip according toanother embodiment of the present disclosure;

FIG. 13B is a schematic diagram of an electrode arrangement of thetissue clip of FIG. 13A;

FIG. 14 is a schematic diagram of a tissue clip according to anotherembodiment of the present disclosure;

FIG. 15 is a system block diagram of the tissue clip of FIG. 14;

FIG. 16 is a schematic diagram of a tissue clip according to anotherembodiment of the present disclosure;

FIG. 17 is a schematic diagram of a tissue clip according to anotherembodiment of the present disclosure;

FIGS. 18A-18C are schematic diagrams of a tissue clip according toanother embodiment of the present disclosure;

FIG. 19 is a schematic diagram of a tissue clip according to anotherembodiment of the present disclosure;

FIG. 20A is a schematic diagram of a tissue clip according to anotherembodiment of the present disclosure;

FIG. 20B is a schematic diagram of a tissue clip according to yetanother embodiment of the present disclosure;

FIG. 21A is a schematic diagram of a tissue clip according to stillanother embodiment of the present disclosure;

FIG. 21B is a schematic diagram of a tissue clip according to yetanother embodiment of the present disclosure; and

FIG. 22 is a system block diagram of a tissue sealing system accordingto another embodiment of the present disclosure.

DETAILED DESCRIPTION

Particular embodiments of the present disclosure are describedhereinbelow with reference to the accompanying drawings; however, thedisclosed embodiments are merely examples of the disclosure and may beembodied in various forms. Well-known functions or constructions are notdescribed in detail to avoid obscuring the present disclosure inunnecessary detail. Therefore, specific structural and functionaldetails disclosed herein are not to be interpreted as limiting, butmerely as a basis for the claims and as a representative basis forteaching one skilled in the art to variously employ the presentdisclosure in virtually any appropriately detailed structure.

Like reference numerals may refer to similar or identical elementsthroughout the description of the figures. As shown in the drawings anddescribed throughout the following description, as is traditional whenreferring to relative positioning on a surgical instrument, the term“proximal” refers to the end of the apparatus that is closer to the userand the term “distal” refers to the end of the apparatus that is fartheraway from the user. The term “clinician” refers to any medicalprofessional (e.g., doctor, surgeon, nurse, or the like) performing amedical procedure involving the use of embodiments described herein.

Electromagnetic energy is generally classified by increasing frequencyor decreasing wavelength into radio waves, microwaves, infrared, visiblelight, ultraviolet, X-rays and gamma-rays. As used herein, the term“microwave” generally refers to electromagnetic waves in the frequencyrange of 300 megahertz (MHz) (3×10⁸ cycles/second) to 300 gigahertz(GHz) (3×10¹¹ cycles/second). As used herein, the term “RF” generallyrefers to electromagnetic waves having a lower frequency thanmicrowaves. As used herein, the term “ultrasound” generally refers tocyclic sound pressure with a frequency greater than the upper limit ofhuman hearing. The terms “tissue” and “vessel” may be usedinterchangeably since it is believed that the present disclosure may beemployed to seal and cut tissue or seal and cut vessels utilizing thesame principles described herein.

The present disclosure is directed to the use of tissue clips inelectrosurgical procedures. The tissue clips can be installed andconfigured to operate independently. When a clip is used on a vessel,the clip can stop blood flow immediately after installation and lets asurgeon proceed without waiting until the installed clip completes thevessel sealing procedure.

The use of the tissue clips in a vessel sealing procedure involvesproviding a tissue clip that may be any one of the tissue clipsdescribed hereinbelow. The tissue clip is placed in the body of apatient approximately near tissue that will be sealed and/or cut. Thetissue is then grasped by the tissue clip using one of the mechanismsdescribed below. Energy is provided to the tissue from the power sourceand the grasped tissue is then sealed before the tissue clip is removed.

As will be described in more detail below, the clip can be positioned ona vessel and then set into the closed position using a suitable surgicalinstrument such as forceps. The closed position provides vesseldeformation and stops the blood flow. After a clip is installed anddetached from the forceps or like instrument, energy is applied to thegrasped tissue and the sealing process begins.

When using the tissue clips of the present disclosure, sealing time isnot as crucial as for typical energy-based instruments. Longer sealingtime lowers the requirements for a power source and, as such, enablesmore compact designs and reduces risk of thermal damage. The use of suchtissue clips also enables the use of different sealing mechanisms suchas soldering and photochemical tissue bonding which require a longertime then RF based sealing.

Referring to FIG. 1A, a tissue clip according to an embodiment of thepresent disclosure is shown generally as tissue clip 100. Tissue clip100 may be used for monopolar or bipolar electrosurgical procedures.Tissue clip 100 includes a body 101 and arm 102. Arm 102 is connected tobody 101 via a flexible joint 103. A hinge or other pivoting mechanismmay be used instead of flexible joint 103. Flexible joint 103 allows theother end of arm 102 to move with respect to body 101. Body 101 includesa protrusion or latch 104 which fixes or selectively locks arm 102 inthe closed position. Tissue that is to be sealed is placed between body101 and arm 102. A gap may be provided by the flexible hinge 103 or stopmembers 190 (FIG. 6) may be used to determine the gap between body 101and arm 102 to provide optimal tissue thickness for a particular sealingmechanism. Typically, the gap is in the range of 0.001 inches to about0.006 inches

Tissue clip 100 includes electrodes 105 a and 105 b on arm 102 and body101, respectively. A power source 106 and control unit 107 are providedin body 101 to provide the necessary voltage to electrodes 105 a and 105b. Control unit 107 transfers electrical power from power source 106 toelectrodes 105 a and 105 b and applies a 100 KHz to 10 MHz frequency toelectrodes 105 a and 105 b. The voltage profile provided by control unit107 may be predetermined and stored in control unit 107 or provided byan external control unit 202 (FIG. 2) via antenna 108. Alternatively,the voltage profile may be adjusted by sensor array 170 (FIG. 6) thatdetermines one or more parameters of the grasped tissue measured beforeor during a sealing process.

In addition to the energy being applied to tissue grasped between body101 and arm 102, body 101 and arm 102 applies a sealing pressure totissue grasped therebetween. In one embodiment, the sealing pressure isin the range of 3 Kg/cm² to 16 Kg/cm². Sealing pressure may be appliedusing different methods as shown in FIGS. 1A-1C. For instance, as shownin FIG. 1A, when arm 102 is locked in the closed position by protrusion104, a predetermined sealing pressure is maintained. Alternatively, abiasing member may be provided to generate the appropriate sealingpressure. A biasing member 132 may be substituted for hinge 103, asshown in FIG. 1B or a biasing member 134, 136 may be attached toelectrodes 105 a and 105 b, as shown in FIG. 1C.

In FIG. 1B, biasing member 132 is used to move arm 102 from a firstposition to a second position closer to body 101 to grasp tissue.Biasing member 132 may be a spring loaded component that applies apredetermined sealing pressure to grasped tissue. Alternatively, biasingmember 132 may be driven by a motor that may be manufactured usingmicro-electromechanical systems (MEMS) technology. The motor may becontrolled by control unit 107 based on: a sealing pressure detected bysensor array 170 (FIG. 6); an algorithm stored in control unit 107; analgorithm provided to control unit 107 from control unit 202; or a userinput provided from control unit 202.

In FIG. 1C, biasing members 134 and 136 may be attached to electrodes105 a and 105 b, respectively. Although two biasing members are shown, asingle biasing member attached to one electrode or both electrodes maybe used. Biasing members 134 and 136 may be a spring-loaded componentthat moves at least one of the electrodes toward or away from each otherto apply a predetermined sealing pressure to grasped tissue.Alternatively, biasing members 134 and 136 may be driven by a motor thatmay be manufactured using MEMS technology. The motor may be controlledby control unit 107 based on: a sealing pressure detected by sensorarray 170 (FIG. 6); an algorithm stored in control unit 107; analgorithm provided to control unit 107 from control unit 202; or a userinput provided from control unit 202.

The tissue clips may be used with an external control unit 202, as shownin FIGS. 2 and 3. Control unit 202 may communicate with tissue clips 100using suitable methods such as Bluetooth communication, radiocommunication, communication similar to the use of radio frequencyidentification tags or any other wireless communication. Externalcontrol unit may transmit instructions to tissue clips 100 while tissueclips 100 may transmit results as well as measured tissue parameters.Based on the received data, control unit 202 may send instructions totissue clips 100, which set the voltage and frequency according to thereceived instructions. One external control unit 202 may be used tocontrol multiple tissue clips.

FIG. 3 depicts a system block diagram of an embodiment of the presentdisclosure. Control unit 202 may include an input device 221, a display222, memory 223, processor 224 and a transceiver 225 coupled to anantenna 226. Input device 221 may include buttons, knobs, switches orthe like to input information for control unit 202 as well as tissueclips 100. Display 222 may show the status of the vessel sealingprocedure, parameters measured by sensor array 170, status of individualtissue clips (e.g., malfunction, damaged, properly working, batterylife, etc.) and time left in the electrosurgical procedure, time elapsedduring the electrosurgical procedure.

Memory 223 may be volatile type memory (e.g., RAM) and/or non-volatiletype memory (e.g., flash media, disk media, etc.) that stores programsor sets of instructions that may be used to control the vessel sealingprocedure. Processor 224 may be an integrated circuit or may includeanalog and/or logic circuitry that may be used to: execute instructionsaccording to inputs provided by the input device 221 or sensor array170, execute instructions according to a program provided in memory 223;and control operation of control unit 202 and/or tissue clip 100. Theprocessor 224 sends a control signal to tissue clip 100 via transceiver225 and antenna 226.

Control unit 202 transmits instructions to tissue clip 100, whichreceives the instructions through antenna 108. The instructions aredecoded by control unit 107, which then transfers power from powersource 106 to electrodes 105 a and 105 b according to the receivedinstructions. Control unit 107 may apply energy to a terminal 105 c thatmay be coupled to an electrode 1026 (FIG. 10) to be used for cuttingtissue.

Control unit 107 may perform a diagnostic check on tissue clip 100. Ifthe tissue clip is defective or malfunctioning, a red light emittingdiode (LED) 182 may be illuminated. If the tissue clip is functioningproperly, a green LED 184 may be lit. Tissue clip also includes a sensorarray 170 that determines properties of tissue between electrodes 105 aand 105 b as well as output voltage, current, impedance and power fromcontrol unit 107. The detected tissue properties provide feedback to thecontrol unit 107 or external control unit 202 to control the output ofcontrol unit 107 via an open loop or closed loop scheme.

Power source 106 may be a rechargeable battery and may be coupled to aterminal 160 that may be used to recharge power source 106. As shown onFIG. 1A, arm 102 may have a contact 110 and body 101 may have a contact111 as a safety check. The tissue clip is not operational until contact110 is electrically coupled to contact 111.

FIGS. 4 and 5 depict a tissue clip according to another embodiment ofthe present disclosure shown generally as 200. As shown in FIGS. 4 and5, tissue clip 200 includes a control unit 207. Control unit 207includes a memory 210 and a processor 220. Memory 210 may include aprogram or set of instructions that can be used to control the voltageoutput of control unit 207. Tissue clip 200 may also include a terminal230 that may be used to store instructions in memory 207, determine thestatus of the tissue clip, record tissue parameters detected by sensorarray 170 of tissue clip 200. Tissue clip 200 may also include any ofthe biasing members described above with regard to FIGS. 1B and 1C.

As shown in FIG. 6, an array of sensors 170 a-170 e are positionedwithin a cavity defined between arm 102 and body 101. The sensors 170a-170 e are configured to automatically sense various properties of thetissue disposed between the arm 102 and body 101 and provide feedback tothe control unit 107, 207 or 202 during the sealing process. Suchproperties include, but are not limited to: tissue impedance, tissuetype, tissue clarity, tissue compliance, temperature of the tissue orjaw members, water content in tissue, jaw opening angle, water motilityin tissue, energy delivery sealing pressure and/or jaw closure pressure.During the sealing process, the sensors 170 a-170 e, control unit 107,207, and/or 202, all cooperate to regulate the sealing procedure ontissue to conform to a predetermined algorithm.

As mentioned above, the arm 102 and/or body 101 may include one or morestop members 190 which limit the movement of the arm 102 and/or body 101relative to one another. The stop member(s) 190 may be configured toextend from the electrode 105 a and/or 105 b a predetermined distanceaccording to the specific material properties (e.g., compressivestrength, thermal expansion, etc.) to yield a consistent and accurategap distance “G” during sealing. In some embodiments, the gap distancebetween the arm 102 and body 101 during sealing ranges from about 0.001inches to about 0.006 inches and, in one particularly useful embodiment,between about 0.002 and about 0.003 inches. The non-conductive stopmember(s) 190 may be molded onto the arm 102 and/or body 101 (e.g.,overmolding, injection molding, etc.), stamped onto the arm 102 and/orbody 101 or deposited (e.g., deposition) onto the arm 102 and/or body101.

Turning to FIG. 7, an electrode suitable for use in a tissue clipaccording to another embodiment of the present disclosure is showngenerally as 705. As shown in FIG. 7, electrode 705 includes a stainlesssteel layer 710 and a copper layer 712. Copper layer 712 partiallycovers stainless steel layer 710. Electrode 705 may be formed bycladding a sheet of copper to a sheet of stainless steel and thenstamping out or machining the bonded sheets into the shape of electrode705. Then a photolithography procedure may be used to etch portions ofthe copper from the edges of the electrode 705 leaving a heating section714. By etching out the copper from electrode 705, only heating section714 applies heat to tissue during a vessel sealing procedure. By notapplying heat along the edges of electrode 705, charring of tissueduring a vessel sealing procedure may be reduced. An energy source 720,which may include a control unit and/or battery as described above, maybe used to provide electrosurgical energy to electrode 705.

Turning to FIG. 8, an exploded view of electrode 805 suitable for use ina tissue clip according to another embodiment of the present disclosureis shown. Electrode 805 includes an insulative plate 804 that is a flexcircuit. Flex circuits are used to assemble electronic circuits bymounting electronic devices on flexible plastic substrates. Such plasticsubstrates may include, but are not limited to, polyimide or polyetherether ketone (PEEK) film. Flex circuits may also be constructed byscreen printing silver circuits onto polyester. As shown in FIG. 8insulative plate 804 has a substrate 806 having circuit traces 812formed thereon. Circuit traces 812 may be made from copper, silver, orany other electrical conductor. Circuit traces 812 may be formed by anysuitable method. For instance, circuit traces 812 may be formed byadhering a conductive layer to substrate 806. Using photolithography, amask outlining circuit traces 812 may be formed and then the conductivelayer may be etched to leave circuit traces 812.

Circuit traces 812 include contacts 810 that may be made from copper,silver or any other electrical conductor. Contacts 810 may be made fromthe same material as circuit traces 812 or from a material differentfrom circuit traces 812. Each contact 810 is operatively coupled tosensor array 820 via contact traces 816. Contacts 810 and contact traces816 are formed using the same techniques that may be used to formcircuit traces 812. The location of contacts 810 correspond to thelocation of piezo electric sensors 890. Accordingly, when piezo electricsensors 890 measure or detect a tissue property, piezo electric sensors890 provide a signal to controller 820 indicative of tissue propertiesvia contacts 810 and contact traces 816.

Electrode 805 includes a seal plate 802. Seal plate 802 is made fromstainless steel, and as described above, has piezo electric sensors 890disposed therein in locations 892. Seal plate 802 may be formed by anysuitable method. For instance, a layer of stainless steel may beprovided and shaped to form seal plate 802. Then, a photolithographymask is applied to seal plate 802 leaving locations 892 exposed. Anetching solution is applied to seal plate 802 to etch away exposedlocations 892. Then the mask is removed leaving seal plate 802 withlocations 892 etched away. When electrode 805 is assembled, piezoelectric sensors 890 are placed in locations 892 of seal plate 802 andare coupled to contacts 810 of insulative plate 804.

Turning to FIG. 9, an electrode suitable for use in a tissue clipaccording to another embodiment of the present disclosure generallydesignated as 905 is shown. Electrode 905 is located on an arm of atissue clip (e.g., 102 of tissue clip 100) and has an outer layer 905 aformed from glass or other isolative non-stick material. Layer 905 b maybe a flex circuit having a coil 910 formed on a flexible plasticsubstrate 912. Such flexible plastic substrates 912 may be formed from,but are not limited to, polyimide, polyether ether ketone (PEEK) film orpolylaminate. Flex circuits may also be constructed by screen printingsilver circuits onto polyester.

Coil 910 may be made from copper, silver, or any other electricalconductor. Coil 910 may be formed by any suitable method. For instance,coil 910 may be formed by adhering a conductive layer to flexibleplastic substrate 912. Using photolithography, a mask outlining coil 910may be formed and then the conductive layer may be etched to leave coil910. Coil 910 may be coupled to an energy source 920.

When energy is applied to coil 910 in electrode 905 and a steel plate(not shown) located on a body of a tissue clip (e.g., body 101 of tissueclip 100) is positioned within an electromagnetic field caused by theapplication of energy to coil 910, heat is generated in tissue disposedbetween electrode 905 and the steel plate. Electrode 905 may have one ormore coatings of a non-stick material. Therefore, tissue would not touchhot metal surfaces and sticking would be reduced. Further, since no heatenergy would be applied to the electrode 905 (heat is generated in thetissue) the efficiency and speed of the seal would increase.

As seen in FIG. 10, an electrode assembly 1005 having a first electrode1005 a located on an arm of the tissue clip (e.g., arm 102 of FIG. 1A)and a second electrode 1005 b on a body of the tissue clip (e.g., body101 of FIG. 1A) are shown and are designed to effectively seal and cuttissue disposed between sealing surfaces 1012 a, 1012 b and 1022 a, 1022b and cutting element 1026 of the opposing electrodes 1005 a and 1005 b,respectively. More particularly, and with respect to FIG. 10, electrodes1005 a and 1005 b include conductive tissue contacting surfaces 1012 a,1012 b and 1022 a, 1022 b, respectively, disposed along substantiallythe entire longitudinal length thereof (e.g., extending substantiallyfrom the proximal to distal end of the respective arm and body of atissue clip). Tissue contacting surfaces 1012 a, 1012 b and 1022 a, 1022b may be attached to arm or body by stamping, by overmolding, bycasting, by overmolding a casting, by coating a casting, by overmoldinga stamped electrically conductive sealing plate and/or by overmolding ametal injection molded seal plate or in other suitable ways.

With respect to FIG. 10, the opposing electrodes 1005 a and 1005 b bothinclude an insulator or insulative material 1014 and 1024, respectively,disposed between each pair of electrically conductive sealing surfaceson the opposing electrodes 1005 a and 1005 b, e.g., between pairs 1012 aand 1012 b and between pairs 1022 a and 1022 b. Insulator 1014 isgenerally centered between tissue contacting surfaces 1012 a, 1012 bthereof along substantially the entire length the arm of the tissueclip. Insulators 1024 are generally centered along substantially theentire length of the body of the tissue clip. Insulators 1014 and 1024are arranged such that the insulator 1014 generally opposes insulators1024.

One or all of the insulators 1014 and 1024 may be made from a ceramicmaterial due to the hardness of the ceramic and inherent ability towithstand high temperature fluctuations. Alternatively, one or both ofthe insulators 1014 and 1024 may be made from a material having a highComparative Tracking Index (CTI) having a value in the range of about300 to about 600 volts. Examples of high CTI materials include nylonsand syndiotactic polystyrenes. Other suitable materials may also beutilized either alone or in combination, e.g., Nylons,Syndiotactic-polystryrene (SPS), Polybutylene Terephthalate (PBT),Polycarbonate (PC), Acrylonitrile Butadiene Styrene (ABS),Polyphthalamide (PPA), Polymide, Polyethylene Terephthalate (PET),Polyamide-imide (PAI), Acrylic (PMMA), Polystyrene (PS and HIPS),Polyether Sulfone (PES), Aliphatic Polyketone, Acetal (POM) Copolymer,Polyurethane (PU and TPU), Nylon with Polyphenylene-oxide dispersion andAcrylonitrile Styrene Acrylate.

Electrode 1005 b includes an electrically conductive cutting element1026 disposed substantially within insulators 1024. As described indetail below, the cutting element 1026 may play a dual role during thesealing and cutting processes, namely: 1) to provide the necessary gapdistance between conductive surfaces 1012 a, 1012 b and 1022 a, 1022 bduring the sealing process; and 2) to electrically energize the tissuealong the previously formed tissue seal to cut the tissue along theseal. With respect to FIG. 10, cutting element 1026 is electricallyconductive; however, cutting element 1026 may be made from an insulativematerial with a conductive coating disposed thereon. The distancebetween cutting element 1026 and insulator 1014 may be disposed withinthe range of about 0.000 inches to about 0.040 inches to optimize thecutting effect.

During the so called “sealing phase”, the opposing electrodes 1005 a and1005 b are closed about tissue and the cutting element 1026 may form therequisite gap between the opposing sealing surfaces 1012 a, 1022 a and1012 b, 1022 b. During activation of the sealing phase, the cuttingelement 1026 is not necessarily energized such that the majority of thecurrent is concentrated between opposing sealing surfaces, 1012 a and1022 a and 1012 b and 1022 b, to effectively seal the tissue. Stopmembers (not shown) may also be employed to regulate the gap distancebetween the sealing surfaces in lieu of or in combination with cuttingelement 1026.

Cutting element 1026 may be configured to extend beyond the tissuecontacting surfaces 1012 a, 1012 b and 1022 a, 1022 b such that cuttingelement 1026 acts as a stop member that creates a distance “d” betweenopposing conductive sealing surfaces 1012 a, 1022 a and 1012 b, 1022 b,which as mentioned above promotes accurate, consistent and effectivetissue sealing. Distance “d” is typically within the above-mentioned gaprange. In one embodiment, the distance “d” has a minimum distance ofabout 0.005 inches for proper effect without stopping the current flowbetween the cutting element 1026 and tissue contacting surfaces 1012 a,1012 b and 1022 a, 1022 b. As can be appreciated, cutting element 1026also prevents the opposing tissue contacting surfaces 1012 a, 1022 a and1012 b, 1022 b from touching, which eliminates the chances of theforceps 10, 100 shorting during the sealing process.

During sealing, energy is applied to the tissue through the opposingsealing plates 1012 a, 1022 a and 1012 b, 1022 b to effect two tissueseals on either side of the insulators 1014 and 1024. During the cuttingphase, sealing electrodes 1012 a, 1012 b and 1022 a, 1022 b areenergized to a first potential “−” and cutting element 1026 is energizedto the second electrical potential “+”. As a result thereof, during thecutting phase, energy is transferred between cutting element 1026 andsealing electrodes 1012 a, 1012 b and 1022 a, 1022 b thereby cuttingtissue disposed between electrodes 1005 a and 1005 b.

In another embodiment, control unit 107 is configured to determine whentissue grasped by the tissue clip is sealed based on tissue propertiesdetected by sensor array 170. When the control unit determines that thetissue has been sealed, control unit 107 automatically provides energyto terminal 105 c, which is coupled to cutting element 1026, to cut thetissue grasped by the tissue clip.

FIGS. 11 and 12 depict a tissue clip 1100 according to anotherembodiment of the present disclosure. As shown in FIGS. 11 and 12,tissue clip 1100 includes a control unit 1107 and a transducer 1105.Control unit 1107 transfers energy from power source 106 to transducer1105 to apply ultrasonic energy to tissue disposed between arm 102 andbody 101. As described above antenna 108 may receive instructions froman external control unit 202. Alternatively, control unit 1107 mayinclude a memory and a processor. Memory may include a program or set ofinstructions that can be used to control the voltage output of controlunit 1107. Tissue clip 1100 may also include any of the biasing membersdescribed above with regard to FIGS. 1B and 1C.

FIGS. 13A and 13B depict a tissue clip according to another embodimentof the present disclosure shown generally as 1300. Tissue clip 1300includes a power source 1330, control unit 1320 and a light source 1310.Light source 1310 may be coupled to long period fiber gratings 1305 aand 1305 b that emits light. Tissue clip 1300 may be used for opticalsoldering or photochemical tissue bonding. In the case of opticalsoldering, a soldering material may be applied (e.g., albumin) ontotissue between fiber gratings 1305 a and 1305 b. The soldering materialmay have a dye added thereto to reduce the amount of energy required dueto the dye's absorption of certain wavelengths which is not absorbed bytissue. Light then heats the dye which in turn heats the solder. In thecase of photochemical tissue bonding, a photosensitizer is added to thevessel before it is activated by light. This results in establishingcovalent cross links without collagen denaturizing or heat-inducedtissue damage. Tissue clip 1300 may also include any of the biasingmembers described above with regard to FIGS. 1B and 1C.

As shown in FIG. 13B, a cutting element 1350 is disposed between fibergrating 1305 b. Cutting element 1350 is selectively moveable from afirst position below the surface of fiber grating 1305 b to a secondposition to cut tissue grasped by tissue clip 1300. Although FIG. 13bdepicts the cutting mechanism disposed in the body between fiber grating1305 b, cutting mechanism 1350 patent may be disposed in the arm betweenfiber rating 1305 a. Cutting mechanism 1350 may be incorporated into anyof the embodiments described herein.

Alternatively, cutting mechanism 1350 may be an electrode coupled tocontrol unit 1320. After a seal is completed, control unit 1320transfers power from power source 1330 to cutting mechanism 1350 toelectrically cut tissue. Cutting mechanism 1350 may also be a lightsource that emits a focused beam of light (i.e., a laser) to cut tissue.The light source may be a semiconductor laser or any other device thatemits a focused beam of light.

FIGS. 14 and 15 depict a tissue clip 1400 according to anotherembodiment of the present disclosure. As shown in FIGS. 14 and 15,tissue clip 1400 includes a control unit 1407 and an antenna array 1405.Control unit 1407 transfers energy from power source 106 to antennaarray 1405 to apply microwave energy to tissue disposed between arm 102and body 101. The microwave energy return to the control unit via returnpad 1405 b. As described above antenna 108 may receive instructions froman external control unit 202. Alternatively, control unit 1407 mayinclude a memory and a processor. Memory may include a program or set ofinstructions that can be used to control the voltage output of controlunit 1407. Tissue clip 1400 may also include any of the biasing membersdescribed above with regard to FIGS. 1B and 1C.

FIG. 16 depicts a tissue clip according to another embodiment of thepresent disclosure shown generally as 1600. Tissue clip 1600 includes anelectrode assembly 1610 that is removably coupled to body 1620.Electrode assembly 1610 includes electrodes 1615 that are coupled toterminals 1616 and 1618. Electrodes 1615 are located on a pair of arms1611 and 1612 that are coupled to each other via a flexible hinge 1613.Terminals 1616 and 1618 are removably coupled to terminals 1626 and 1628of body 1620. Body 1620 includes a control unit 1624 and a power source1622. Body 1620 and electrode assembly 1610 may include any of thefeatures described hereinabove. Electrode assembly 1610 may beabsorbable while body 1620 may be reusable by sterilizing body 1620 andcoupling body 1620 to a different electrode assembly 1610. Tissue clip1600 may also include any of the biasing members described above withregard to FIGS. 1B and 1C.

FIG. 17 depicts a tissue clip according to another embodiment of thepresent disclosure shown generally as 1700. Tissue clip 1700 includes anelectrode assembly 1610 that is removably coupled to body 1710.Electrode assembly 1610 includes electrodes 1615 that are coupled toterminals 1616 and 1618. Electrodes 1615 are located on a pair of arms1611 and 1612 that are coupled to each other via a flexible hinge 1613.Terminals 1616 and 1618 are removably coupled to terminals 1626 and 1628of body 1710. Body 1710 includes a control unit 1624 and an antenna1625. Body 1710 and electrode assembly 1610 may include any of thefeatures described hereinabove. A battery pack 1720 is removably coupledto body 1710 by coupling terminal 1722 to terminal 1712. Battery pack1720 includes a battery 1622 that may be a single use battery or arechargeable battery. Electrode assembly 1610 may be absorbable whilebody 1710 and/or battery pack 1720 may be reusable by sterilizing body1710 and/or battery pack 1720 and coupling body 1710 and/or battery pack1720 to a different electrode assembly 1610. Tissue clip 1700 may alsoinclude any of the biasing members described above with regard to FIGS.1B and 1C. Alternatively, electrode assembly may be coupled to a housing(not shown). The housing may be configured to receive body 1710 and/orbattery pack 1720.

FIGS. 18A-18C depict a tissue clip 1800 according to another embodimentof the present disclosure. Tissue clip 1800 includes an arm 1810 that isremovably coupled to body 1820. Arm 1810 includes an electrode 1814 anda retaining clip 1812. Body 1820 includes an electrode 1824 and aretaining lip 1822. Retaining clip 1812 and retaining lip 1822 are usedto fix or selectively lock arm 1810 to body 1820 to grasp tissuedisposed therebetween. Arm 1810 may include a power source 1815, controlunit 1816 and sensor array 1817 similar to any of the power sources,control units and/or sensor arrays described above. Body 1820 mayinclude a power source 1825, control unit 1826 and sensor array 1827similar to any of the power sources, control units and/or sensor arraysdescribed above.

FIG. 19 depicts a tissue clip 1900 according to another embodiment ofthe present disclosure. Tissue clip 1900 includes a first arm 1901 and asecond arm 1902 that are coupled together by a helical torsion spring1910. First arm 1901 includes a power source 1906, control unit 1907,antenna 1908 and electrode 1905 a. Second arm 1902 includes electrode1905 b Although FIG. 19 shows the power source 1906, control unit 1907,and antenna 1908 in first arm 1901, the power source 1906, control unit1907, and antenna 1908 may be disposed in second arm 1902 or both thefirst arm 1901 and the second arm 1902. Power source 1906 is similar tothe power sources described hereinabove. Control unit 1907 stores aprogram that, when executed, causes tissue clip 1900 to seal tissuegrasped between distal ends 1941 and 1942 of first arm 1901 and secondarm 1902, respectively. Antenna 1908 is configured to receiveinstructions from an external control unit or transmit information froma sensor (not shown) to an external control unit.

Tissue clip 1900 may be effective in emergency situations where accessto hospitals is limited such as rural areas or combat situations. Inoperation, a user presses proximal ends 1931 and 1932 of first arm 1901and second arm 1902, respectively, towards each other causing distalends 1941 and 1942 to move away from each other. Tissue is placedbetween the distal ends 1941 and 1942 and then proximal ends 1931 and1932 are released causing helical torsion spring 1920 to bias distalends 1941 and 1941 toward each other to grasp tissue therebetween underthe appropriate pressure to seal tissue. Stop members 1920 may beconfigured to extend from the electrode 1905 a and/or 1905 b apredetermined distance according to the specific material properties(e.g., compressive strength, thermal expansion, etc.) to yield aconsistent and accurate gap distance during sealing. In someembodiments, the gap distance between the first arm 1901 and second arm1902 during sealing ranges from about 0.001 inches to about 0.006 inchesand, in one particularly useful embodiment, between about 0.002 andabout 0.003 inches.

Helical torsion spring 1901 causes first arm 1901 and second arm 1902 toapply a sealing pressure to tissue grasped therebetween. In oneembodiment, the sealing pressure is in the range of 3 Kg/cm² to 16Kg/cm².

FIG. 20A depicts a tissue clip according to another embodiment of thepresent disclosure. As shown in FIG. 20A, tissue clip 2000 includes acontrol portion 2010 and a clip portion 2020. Control portion includes apower source 2006, control unit 2007, and antenna 2008. Power source2006 is similar to the power sources described hereinabove. Control unit2007 stores a program that, when executed, causes tissue clip 2000 toseal tissue grasped between arm 2022 and arm 2023. Antenna 2008 isconfigured to receive instructions from an external control unit ortransmit information from a sensor (not shown) to an external controlunit.

Clip portion 2020 may be made from a shape memory alloy 2021, e.g.,copper-zinc-aluminum-nickel, copper-aluminum-nickel, and nickel-titanium(NiTi) alloys. Shape memory alloy 2021 may exhibit a one way effect ortwo-way effect. When outside the body, shape memory material is in anopen shape with arm 2022 and arm 2023 spaced apart from each other. Whentissue clip 2000 is placed inside a body, heat within the body causesclip portion 2020 to heat up past the austenitic start temperature(A_(s)) causing the shape memory alloy 2021 to change to its originalshape where arm 2022 and arm 2023 are positioned relatively closer toeach other to grasp tissue disposed therebetween.

Arm 2022 and arm 2023 include electrodes 2005 a and 2005 b,respectively. Electrodes 2005 a and 2005 b are disposed withininsulators 2024 to electrically isolate electrodes 2005 a and 2005 bfrom shape memory alloy 2021. Insulator 2024 may be composed of anynon-conductive material.

Arm 2022 and arm 2023 are configured to yield a consistent and accurategap distance, which may range from 0.001 inches to about 0.006 inches,during sealing when clip portion 2020 is in its original shape. Further,arm 2022 and arm 2023 may apply a sealing pressure to tissue graspedtherebetween when clip portion 2020 is placed in its original austeniticshape. In one embodiment, the sealing pressure is in the range of 3Kg/cm² to 16 Kg/cm².

Although FIG. 20A depicts the control portion 2010 and clip portion 2020as one unit, control portion 2010 may be removably coupled to clipportion 2020. Further, in some embodiments, control portion 2012 oftissue clip 2000 may only contain a power source 2006.

FIG. 20B depicts a tissue clip 2050 according to another embodiment ofthe present disclosure. Tissue clip 2050 is similar to clip portion 2020described above. As depicted in FIG. 20B, tissue clip 2050 includesreceiving coil 2058 that is configured to receive energy from anexternal control unit as will be described below with regard to FIG. 22.

FIG. 21A depicts a tissue clip according to another embodiment of thepresent disclosure. As shown in FIG. 21A, tissue clip 2100 includes acontrol portion 2102 and clip portion 2110. Control portion includes apower source 2106, control unit 2107, and antenna 2108. Power source2106 is similar to the power sources described hereinabove. Control unit2107 stores a program that, when executed, causes tissue clip 2100 toseal tissue grasped between arm 2112 and second arm 2114. Antenna 2108is configured to receive instructions from an external control unit ortransmit information from a sensor (not shown) to an external controlunit.

Clip portion 2110 includes electrodes 2105 a and 2105 b that applyenergy to tissue grasped between arms 2112 and 2114. A spring member2130 is disposed in clip portion 2110 to bias arms 2112 and 2114 towardeach other to grasp tissue therebetween. Arm 2112 and/or arm 2114include stop members 2120 that are configured to yield a consistent andaccurate gap distance, which may range from 0.001 inches to about 0.006inches. Alternatively, spring member 2130 may be configured to achieve adesired gap between arm 2112 and arm 2114. Further, spring member 2130may apply a sealing pressure to tissue grasped between arm 2112 and arm2114. In one embodiment, the sealing pressure is in the range of 3Kg/cm² to 16 Kg/cm².

Although FIG. 21A depicts the control portion 2102 and clip portion 2110as one unit, control portion 2102 may be removably coupled to clipportion 2110. Further, in some embodiments, control portion 2102 oftissue clip 2100 may only contain a power source 2106.

FIG. 21B depicts a tissue clip 2150 according to another embodiment ofthe present disclosure. Tissue clip 2150 is similar to clip portion 2110described above. As depicted in FIG. 21B, tissue clip 2050 includes areceiving coil 2158 that is configured to receive energy from anexternal control unit as will be described below with regard to FIG. 22.

FIG. 22 depicts a tissue clip system 2200 according to anotherembodiment of the present disclosure. Tissue clip system 2200 may use apower source placed outside of a tissue clip 2210 and the energy may betransferred from outside by excitation of an inductive current in areceiving coil placed inside the tissue clip. Different clips may haveresonant receiving coils adjusted to different frequencies such thateach clip can be supplied with power individually. The tissue clip maybe controlled by varying the amplitude of the external electromagneticfield.

As shown in FIG. 22, tissue clip system 2200 includes a tissue clip 2210and an external control unit 2220. Control unit 2220 includes a powersource 2206, a control unit 2207, and transmitting coil 2208. Powersource 2206 is similar to the power sources described hereinabove.Control unit 2207 stores a program that, when executed, causes tissueclip 2210 to seal tissue grasped between electrodes 2205 a and 2205 b.Transmitting coil 2208 generates an electromagnetic field that induces acurrent in receiving coil 2218. The inductive current generated byreceiving coil 2218 is supplied to electrodes 2205 a and 2205 b to sealtissue grasped therebetween.

Although specific examples of tissue clips have been described above,any one of the above described tissue clips may include features fromany of the other described tissue clips. For instance, the use of anexternal power source as described in FIG. 22 may be incorporated intoany of the tissue clips described above.

As mentioned above, it is contemplated that the tissue clip embodimentsdescribed herein can use light, microwave, RF, or resistive energy tothermally treat tissue or seal tissue (as defined herein).

It should be understood that the foregoing description is onlyillustrative of the present disclosure. Various alternatives andmodifications can be devised by those skilled in the art withoutdeparting from the disclosure. Accordingly, the present disclosure isintended to embrace all such alternatives, modifications and variances.The embodiments described with reference to the attached drawing figs.are presented only to demonstrate certain examples of the disclosure.Other elements, steps, methods and techniques that are insubstantiallydifferent from those described above and/or in the appended claims arealso intended to be within the scope of the disclosure.

What is claimed is:
 1. A method of sealing tissue, comprising: graspingand positioning a first tissue clip within a body of a patient using asurgical instrument or a hand; grasping a first portion of tissue of thepatient between an arm and a body of the first tissue clip; releasingthe first tissue clip from the surgical instrument or the hand; andenergizing an electrode of at least one of the arm or the body of thefirst tissue clip by a power source disposed within the body of thefirst tissue clip, thereby sealing the grasped first portion of thetissue, wherein the electrode is energized after the tissue clip isreleased.
 2. The method according to claim 1, wherein the first tissueclip is grasped and positioned within the body of the patient using thesurgical instrument.
 3. The method according to claim 2, whereinreleasing the first tissue clip includes ungrasping the first tissueclip with the surgical instrument.
 4. The method according to claim 1,further comprising: moving the arm away from the body to ungrasp thesealed first portion of the tissue; and removing the tissue clip fromthe body of the patient.
 5. The method according to claim 1, furthercomprising: grasping and positioning a second tissue clip within thebody of the patient with the surgical instrument or the hand; grasping asecond portion of the tissue of the patient between an arm and a body ofthe second tissue clip; releasing the second tissue clip from thesurgical instrument or the hand; and energizing an electrode of at leastone of the arm or the body of the second tissue clip from a power sourcedisposed within the body of the second tissue clip, thereby sealing thegrasped second portion of the tissue, wherein the electrode is energizedafter the second tissue clip is released.
 6. The method according toclaim 5, wherein the second tissue clip is grasped and positioned withinthe body of the patient using the surgical instrument.
 7. The methodaccording to claim 6, wherein releasing the second tissue clip includesungrasping the second tissue clip with the surgical instrument.
 8. Themethod according to claim 5, further comprising removing the first andsecond tissue clips from the body of the patient using the surgicalinstrument or the hand after the first and second portions of the tissueare sealed.
 9. The method according to claim 1, wherein the arm has aproximal end portion movably coupled to a proximal end portion of thebody, the method further comprising moving the arm relative to the bodyto grasp the first portion of the tissue.
 10. The method according toclaim 1, further comprising applying a sealing pressure on the firstportion of the tissue via a biasing member that biases the arm relativeto the body.
 11. The method according to claim 1, further comprisingtransmitting instructions to the first tissue clip from an externalcontrol unit.
 12. The method according to claim 1, wherein grasping thefirst portion of the tissue stops blood flow through the first portionof the tissue.
 13. The method according to claim 1, further comprisingtransferring electrosurgical energy from the power source to theelectrode to energize the electrode using a control unit disposed withinthe first tissue clip.
 14. The method according to claim 1, furthercomprising determining parameters of the first portion of the tissueusing a sensor of the first tissue clip.
 15. The method according toclaim 1, further comprising: sensing that the first portion of thetissue is sealed using a sensor of the first tissue clip; andautomatically activating a cutting element of the first tissue clipafter the sensor senses that the first portion of the tissue is sealed.16. The method according to claim 1, further comprising applying aclosure pressure between 3 kg/cm² to 16 kg/cm² on the first portion ofthe tissue by the arm and the body prior to energizing the electrode.17. The method according to claim 1, further comprising setting a gap inthe range of 0.001 inches to 0.006 inches between the arm and the bodywith a stop member disposed between the arm and the body.
 18. A methodof sealing tissue, comprising: positioning a first tissue clip within abody of a patient using a surgical instrument having the first tissueclip coupled thereto; grasping a first portion of tissue of the patientbetween an arm and a body of the first tissue clip; releasing the firsttissue clip from the surgical instrument; and energizing an electrode ofat least one of the arm or the body of the first tissue clip by a powersource disposed within the body of the first tissue clip, therebysealing the grasped first portion of the tissue, wherein the electrodeis energized after the tissue clip is released.
 19. A method of sealingtissue, comprising: positioning a surgical instrument having a tissueclip coupled thereto within a body of a patient; grasping a portion oftissue of the patient between an arm and a body of the tissue clip;uncoupling the tissue clip from the surgical instrument therebyenergizing an electrode of at least one of the arm or the body of thetissue clip by a power source disposed within the body of the tissueclip thereby sealing the grasped portion of the tissue.